Alcohol and Drug Partnerships (ADP) 2023/2024 Annual Survey

Executive Summary

Responses were received from all 30 Alcohol and Drug Partnerships (ADPs) in Scotland. The survey included sections relating to cross cutting priorities and outcomes in the National Drugs Mission outcomes framework and covered activity over 2023/24. The key findings are:

Cross cutting priority: Surveillance and data informed

• Almost all ADP areas reported having specific groups or structures to inform surveillance and monitoring of drug harms or deaths. Fewer ADPs reported groups relating to alcohol, though several reported having these in development.
• Three quarters of ADPs reported that they had made revisions to protocols in response to emerging threats, such as novel synthetics.

Cross cutting priority: Skilled and resilient and workforce

• ADPs reported that they employed an average of 3.5 whole-time equivalent (WTE) staffing resource routinely dedicated to their ADP support team as of 31 March 2024. This is a slight increase from 3.1 WTE in the 2022/23 survey.
• ADPs reported a range of initiatives undertaken at ADP level or in services to improve employee wellbeing.

Cross cutting priority: Lived and living experience

• All ADPs reported having formal mechanisms in place at an ADP level to gather feedback from people with lived and/or living experience who use ADP-funded services, including as part of the Medication Assisted Treatment (MAT) programme.
• Feedback was most commonly used in service improvement, service design, strategy and board level feedback. It was less commonly reported for use in assessment and appraisal processes for staff.

Cross cutting priority: Stigma reduction

• All ADPs included stigma in at least one written strategy or policy but were less likely to include stigma in communication strategies, drug or alcohol deaths and harms action plans and community action plans.

Outcome 1: Fewer people develop problem substance use

• ADPs reported providing information on local treatment and support services to a range of different audiences. ADPs most commonly used online approaches. In person events were most commonly used to engage with women, and LGBTI+ people were most likely to be engaged with online. Leaflets and posters were most commonly used to target people experiencing homelessness.
• ADPs reported that they funded or supported a range of education and prevention activities for different age groups, with comparatively more for young people than other age groups. Activities varied across age groups, but most commonly related to mental wellbeing, harm reduction and campaigns/information.

Outcome 2: Risk is reduced for people who use substances

• Drug services and mobile/outreach services were most commonly reported to provide most harm reduction initiatives. Naloxone supply was the most frequently reported harm reduction initiative available.
• There were changes in the reported delivery of harm reduction initiatives since last year, including a reduction in ADPs reporting supply of naloxone in some settings.
• Most ADPs reported demand for drug checking and inhalation pipe provision.

Outcome 3: People most at risk have access to treatment and recovery

• Documented pathways for people who experience near-fatal overdose (NFO) were most commonly reported to be in place through the Scottish Ambulance Service and specialist substance use treatment services.
• Issues around information sharing, workforce capacity and insufficient funds were the most commonly reported barriers to implementing NFO pathways.
• ADPs reported a range of ways in which they work with justice partners at strategic, operational and service level. ADPs also reported supporting a range of activities at different stages of engagement with the justice system.
• Compared to last year’s survey, for most activities, the percentage of ADPs supporting activities at pre-arrest and in police custody had increased. Like last year, activities were most commonly supported upon release, and were least likely to be supported in court.
• The most commonly supported activities across the criminal justice system were referrals to treatment services, harm reduction interventions, alcohol interventions, Opioid Substitution Therapy (OST) and drug and alcohol use treatment needs screening.

Outcome 4: People receive high quality treatment and recovery services

• All ADP areas reported having screening options in place to address alcohol harms. A wide range of alcohol treatment options were available in most ADP areas.
• The most common barrier to residential rehabilitation was insufficient funds, reported in three quarters of ADP areas.
• The most commonly reported barriers to implementing MAT were insufficient funding, geographical challenges and accommodation challenges.
• ADPs reported a range of treatment and support services in place specifically for children and young people using alcohol and/or drugs. The widest variety of services were reported for young people. Across all age groups, family support services, diversionary activities, mental health and support/discussion groups were the most commonly reported services.

Outcome 5: Quality of life is improved by addressing multiple disadvantages

• Specific treatment and support services were reported to be widely in place for women, people who are pregnant or perinatal and people who are experiencing homelessness, and less commonly for people with learning disabilities and literacy difficulties and people with hearing and/or visual impairments.
• Nearly nine in ten ADPs reported that they had formal joint working protocols in place to support people with co-occurring substance use and mental health diagnosis to receive mental health care. This was a 28 percentage point increase from last year’s survey. Nearly all ADPs had arrangements in place within their area for people who present at substance use services with undiagnosed mental health concerns.
• Approaches ADPs used to work with other support services, such as welfare advice and housing support, included partnership working and representation on strategic groups.
• All ADPs reported a range of activities undertaken in ADP-funded or supported services to implement a trauma-informed approach.
• Over nine in ten ADPs reported that they have a specific referral pathway for people to access independent advocacy, with most being commissioned directly by the ADP.

Outcome 6: Children, families and communities affected by substance use are supported

• ADPs reported a range of treatment and support services in place for children and young people who are affected by a parent or carer’s substance use. The most commonly provided services were carer support, diversionary activities and family support.
• Support services were widely reported for adults affected by another person’s substance use, including naloxone training, support groups and commissioned services.
• Over three quarters of ADPs have an agreed set of activities and priorities with local partners to implement the Holistic Whole Family Approach Framework in their ADP area.
• ADPs reported a range of services in place to support Family Inclusive Practice or Whole Family Approach, which were similar for those with family members both in and out of treatment, including advice, peer support, advocacy and social activities.